Improving Womens Reproductive Health - Essay Example

Name: Tutor: Title: Improving Women’s Reproductive Health Course: Date Introduction The present era has experienced the emergence of a growing interest in the reproductive health of women. Scholars, researchers, policy makers, health care providers, health advocates and feminists have realized that investing in women’s health is the key to reducing infant and maternal mortality (Robinson, 2001). Developing and developed countries have been using state-based approach that involves use of force to control and regulate women’s health. Despite this, some developing countries have continued to experience high rates of child and maternal mortality. This has necessitated the need for a global shift from the state-based approach to women’s health a women-centred approach to women’s health with the aim of improving the reproductive health of women globally (Sen, Gennain, and Chen, 1994). This paper will explore the impact of this shift in terms of the reproductive health of women and the experience of women’s health in developing countries. The paradigm shift from a macro-level to a micro-level management of the women’s reproductive health focuses on the rights of women, reproductive choice, sexual behaviour and gender inequality (Lane, 1994). Reproductive health programmes can only be successful if women are fully involved in the process of identifying their health issues so as to make the services offered to them cultural acceptable and applicable to their lives. This can result in women empowerment, creating a way for women to mobilise to have their rights for reproductive health. Scholars and health advocates have realized that marginalization of women has an adverse effect on their reproductive health and rights. As a result, they are advocating for a woman-centred approach to women’s reproductive health (Robinson, 2001). A woman-centred approach to women’s health seeks to guarantee that every woman can access reproductive health. It offers a framework for treatment, care and prevention which acknowledges women play a significant role in their communities and hence focuses on the obstacles and risks they face in accessing their own reproductive health care (Edstrom, 2010). Hence, this approach addresses the diverse women’s needs and conditions so as to ensure that all women have equal access to reproductive health. To create an environment whereby women can attain the highest standards of reproductive health, developing and developed countries need to recognize and deal with the cultural, social, economic and legal factors that hinder women from accessing reproductive health services. Every woman needs to have access to a range variety of information and services that she requires to enable her make informed choices as regards her reproductive health as well as to care for her needs as well as for those of her family members. The social and biological needs of women can only be satisfied if they are provided with health services and the resources required for them to gain access to those services (Green, et al. 2001). There is a global consensus among all scholars and health care providers that only a woman-centred approach that empower women, protect their health rights and promote their reproductive and sexual health can improve the conditions of women globally. Empowering women in all areas of their lives can result in gender equity since the power relations which impede women from attaining healthy reproductive lives operate at numerous level of society. The global community is in agreement that gender equity is necessary condition for the attainment of perfect reproductive health and hence has agreed to support gender mainstreaming in reproductive health programmes (Harcourt, 2009). Experiences of women’s health in Developing Countries Many developing countries have unequal distribution of power and this implies that women basically have limited control over and access to health care, information, resources and services to protect their reproductive health. As a result of this, HIV/AIDS has been the major cause of women’s death in these countries, with unsafe sex being the major risk factor. Moreover, almost all the 500,000 maternal deaths which take place every year have been reported in developing countries. Stigma associated with certain disease may hinder women from seeking treatment (Filipp, et al 2006). Biologically, women have a long lifespan than men, meaning that they are more likely to live for an extended period of time compared to them. Also, biologically, women are four times prone to contracting HIV and other sexual transmitted diseases compared to men. Moreover, the immunity of women is compromised for the period of their pregnancy leaving them more likely to get infected with malaria. Women suffering from malaria during their pregnancy are more probably to face maternal mortality, obstructed labour, hypertension disorders, infections, stillbirth and spontaneous abortion (FEMNET, 1993). Although figures shows that there has been an increase in the use of contraceptive in the past three decades, considerable contraceptive needs remain unfulfilled in these countries, in particular Africa, Asia and Latin America. Increased male responsibility in African societies has resulted in greater men control over women’s reproductive health. Women cannot use contraceptive without the men’s permission, meaning they have no control over the number of children they can bear. In Indonesia, the government implemented a rigorous family planning program that led to great decline in fertility rates (Filipp, et al 2006). Women in developing countries have been denied their rights to reproductive health. In Southern countries, women have been coerced by physicians to undergo sterilization, meaning that they don’t have power over their childbearing. Moreover, the women of Indonesia, Egypt, Thailand and the Dominican Republican were denied the right to remove their Norplant contraceptive implants despite experiencing adverse effects that included irregular bleeding. In addition, in Peru, women have been used to test emerging contraceptive technologies, especially the Cydofem and Norplant. Furthermore, in Zimbabwe, a case has been documented whereby a girl had gotten pregnant after being raped but her request for permission to procure abortion was approved one month after she gave birth as the case dragged for long in the court (FEMNET, 1993). While education plays a crucial role in decreasing HIV infection and unwanted pregnancies, developing countries have experienced major difficulties in making education universal for girls. In most developing countries, there is a trend towards son preference in education and this implies that daughters are more likely not to receive education. This situation is made worse by the high poverty levels in evident in families in developing countries which makes it hard for these families to send both the boy and the girl child to school. A study has shown that violence against women is prevalent in developing countries. It demonstrated that women who have experienced physical abuse are more likely to be victims of unwanted pregnancies, miscarriages and abortions compared to those who have not experienced physical abuse (Ecks & Sax, 2005). Domestic violence is well documented in Bulgaria. Women who experience sexual violence are at high risks of getting infected with HIV and STDs. To make it worse, when these women contract these diseases they are abandoned by their partners. Hence, gender-based violence can be said to be a hindrance to women’s participation in their reproductive health. Sexual slavery is also prevalent in Eastern Europe and Southeast Asia (Jolly and Ram, 2001). The high rates of diseases and death associated with reproduction and sex that characterize lives of women in developing countries can be attributed to the glaring gender inequality in these countries. Women in developing countries are experience limited access to education, property, income and cultural legal and social norms which limit their control over their own reproduction and sex. This has led to the increase in the rate of violence against women in these countries. The unjust laws regarding property rights, sexual abuse, marriage and lack of enforcement has made women susceptible to financial dependency and reduces their influence in decision-making (Jolly and Ram, 2001). Financial hardships and limited access to income has compelled women to involve themselves in sexual behaviour, such as prostitution, intergenerational sex, and intimate partner violence that have exposed them to sexual transmitted diseases and even death. For example, young women in sub-Saharan African engage in prostitution with older men so as they can be able to support their families or pay school fees for their children. This practice increases the risks of young women contracting the HIV virus. Moreover, cultural practices including female genital mutilation, wife inheritance and early child marriages make women prone to HIV infection (Ecks & Sax, 2005). Women are mostly constrained to work at informal sectors and hence their work is not judged as productive as that of men. Generally, women experiences difficulties obtaining title to land, making it hard for them to access loans and other assets. In Africa, the role of women is deemed to be caring for the needs of their families at home and this assumption limit their participation in the supposed productive work. Although, domestic chores, such as cooking, child care, care for the aged, fetching firewood and water and maintaining a clean home are demanding tasks and deemed to be important to households, they usually go unpaid. Lack of time, poor infrastructural facilities, and limited mobility is likely to hinder women from accessing health care. An imbalanced sexual power between men and women manifest in developing countries is likely to make it hard for women to safeguard themselves against HIV and other STDs. In sub-Saharan African, most of the women infected with HIV reported to have a single sex partners while many men living with HIV report several sexual partners (Mensh, 1992). Women are susceptible to coerced sex, such as rape, making them more vulnerable to STDs. Older women and young girls are at higher risks. Since STDS are usually asymptomatic in women, they are more likely to go untreated. Women’s lack of sexual power makes it almost impossible for them to negotiate for safer sex. For example, they cannot tell men to use condoms when having sex with them. The fact that women don’t have a choice when it comes to their reproductive health makes them dependent on men. Moreover, women’s lack of access to income, land and education makes them exposed to cultural responsibilities to marry and get children. The whole responsibility for caring for families infected with AIDS is left to women (Mensh, 1992). A woman-centred Approach The health problems that women experiences in developing countries necessitate the need for a woman-centred approach that aggressively confronts the cultural, social and economic obstacles to reproduction health as a whole (Edstrom, 2010). Such an approach need to cater for the need of all women, especially those are marginalized including prostitutes, injecting drug users as well as the incarcerated. The effectiveness of a reproductive health program relies on its consideration of the issues which limit the status of women in societies, ease of access and quality of health care and their genetic risk of disease. The largest marginalized group in the society comprise of women. Women experiences manifold and compounding types of health-related discrimination during their lifespan due to biological factors and social disadvantages. The key step towards reducing gender inequality lies in creating a social and political environment whereby women are given the power to make decisions concerning their own reproductive health (Schrater, 1995). Improving the health of a woman can have a positive effect on the society she lives in as well as on her own household. Studies have demonstrated that in countries where women are in good physical shape and can make an income, they tend to invest a larger proportion of their earnings on the education and health care of their children than men. Moreover, a survey has shown that use of contraceptives by women can help boost their confidence and status in the family and hence are more likely to participate in the family decision-making process compared to non-contraceptives users (Hardon, 2006). Using contraceptives also helps women to have spaced, fewer and healthy children and this is vital in sealing the gender gap. The introduction of female condoms can come in handy in empowering women in relation to family planning (Kaler, 2001). A woman-centred approach will ensure that women get timely and suitable heath care. Moreover, it will make sure that women get the other determinants of good health, including access to food and water, a healthy environment and freedom from violence. In addition, a woman-centred approach will ensure that all women have access to quality health care regardless of status, race, religion, gender, nationality, ethnicity, disability, marital status, immigration status, sexual orientation or primary language. Young girls can be protected from early marriages by increasing the lawful age of marriage. Moreover, permitting pregnant girls to continue learning and to assume studies after delivery can help improve women’s health. Promoting education parity between boys and girls can also help empower women in marriage (Doyal, 1998). A woman-centred approach will ensure that groups representing different sectors of society are involved in designing reproductive programs that have a direct impact on them. Women, particularly those infected with HIV, need to be given the opportunity to voice as well as prioritize their own reproductive health needs (Edstrom, 2010). A state-based approach towards reproductive health cannot adequately address the issues of women’s health. Women need to be meaningfully engaged in major decision making processes as regards the conceptualization, plan, implementation, assessing and evaluation of programs on global reproductive health problems. Autonomous reproductive choice needs informed decision making. Accurate, timely and pertinent information is critical in this process (Green, et al. 2001). Governments need to work in collaboration with women’s groups. Although, community-based women’s organization are important partners to reproductive health they often do not have access to global donors or relationships with global NGOs. Often, women work in the casual sector and hence women’s groups operate outside of typical NGO societies. A woman-centred approach recognizes the obstacles that women’s groups face when seeking funds and engaging in national and global planning processes and entails mechanisms for obtaining health program funds (Doyal, 1998). Reproductive health deals with intimate and personal aspects of sexuality and thus it is critical for health care providers to respect the privacy, confidentiality and personal integrity of women when providing health care (Harcourt, 2009). Promoting the human rights of women is a fundamental part of improving their health. Women have a right to security, to privacy, to information, to marry and bear children, to opinion and expression and freedom from any form of discrimination, torture and ill treatment. Human rights to education, to health care, to survival and to benefits of scientific progress have been perceived as entitlements that may apply to safe childbirth, abortion and STDs treatment. Human rights are linked to reproduction health and hence are relevant when it comes to formulating reproduction health policies. Provision of high quality health care can lead to protection of human rights. To ensure that women’s rights are protected, standard relating to protection of women’s dignity and autonomy, interpersonal communication and technical quality, including appropriate drugs and safety must be established (Hardon, Ann, Sandra and Elly, 1997). Integrating health care services is critical to improving women’s health. It ensures that women get access to a range variety of services and information at one location and hence it is cost-effective. Moreover, integrating health services ensures that those women who never seek health care are reached. In addition, some services which are essential components of inclusive reproductive health including family planning, maternal health and sexual health work well when they are provided at one location. Furthermore, integrating health services is the best way to guarantee that women, in particular those in greater need such as rural women, low-income women, women living with AIDs and those in need of post-abortion or postpartum, receive information about their rights and health. Integrating services ensure greater continuity of health care (Harcourt, 2009). Conclusion Despite the fact that women enjoy prolonged life expectancy, their life is shortened by the high rates of mortality associated with their reproduction health. Fertility control, infertility, pregnancy, childbirth, reproductive system’s diseases as well as sexually transmitted diseases require health care for women. Reproductive health programs therefore need to be gender-sensitive. A woman-centred approach can increase women’s capacity to make independent reproductive choices using a number of strategies including promoting education for girls, improving women’s status, improving education, information and communication as well as integrating, decentralising and improving reproductive health services. Bibliography Doyal, L. 1998. ‘A Framework for Designing National Health Policies with an integrated Gender Perspective,’ in Women and Health, Mainstreaming the Gender Perspective into the Health Sector, Report from Tunis. Ecks, S. & Sax, W. S. 2005. The Ills of Marginality: New Perspectives on Health in South Asia. Anthropology & Medicine, 12, 199 - 210. 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